Autor(es): Simon Fabrice, Parola Philippe, Grandadam Marc, Fourcade Sabrina, Oliver Manuela, Brouqui Philippe, Hance Pierre, Kraemer Philippe, Ali Mohamed Anzime, de Lamballerie Xavier, Charrel Rémi, Tolou Hugues

Resumo: A large chikungunya virus (CHIKV) outbreak emerged in 2005-2006 in the Indian Ocean isl-s, including Comoros, Mayotte, Mauritius, the Seychelles, - particularly in Reunion Isl- where 35% of 770,000 inhabitants were infected in 6 months. More recently, circulation of the virus has been documented in Madagascar - in India where CHIKV is spreading rapidly. CHIKV-infected visitors have returned home to nonendemic regions from these isl-s. We conducted a 14-month prospective observational study on the clinical aspects of CHIKV infection imported to Marseilles, France, in travelers returning from the Indian Ocean isl-s. A total of 47 patients have been diagnosed with imported CHIKV infection confirmed by serology, reverse transcription-polymerase chain reaction, -/or viral culture. At the early stage of the disease (within 10 days of the disease onset), fever was present in 45 of 47 patients. A rash was present in the first week in 25 cases. All patients suffered with arthritis. The most frequently affected joints were fingers, wrists, toes, - ankles. Eight patients were hospitalized during the acute stage, including 2 severe life-threatening cases. A total of 38 patients remained symptomatic after the tenth day with chronic peripheral rheumatism, characterized by severe joint pain - multiple tenosynovitis, with a dramatically limited ability to ambulate - carry out activities in daily life. Three patients were hospitalized at this stage for severe persistent h-icap. Follow-up demonstrated slow improvement in joint pain - stiffness despite symptomatic treatment, mainly antiinflammatory - analgesic drugs. In the current series we describe 2 stages of the disease, an initial severe febrile - eruptive polyarthritis, followed by disabling peripheral rheumatism that can persist for months. We point out the possibility of transitory peripheral vascular disorders during the second stage - the occasional benefit of short-term corticosteroids. As CHIKV could spread throughout the world, all physicians should be prepared to encounter this arboviral infection.

Imprenta: Medicine, v. 86, n. 3, p. 123-137, 2007

Identificador do objeto digital: 10.1097/MD/0b013e31806010a5

Descritores: Chikungunya virus - DNA ; Chikungunya virus - Pathogenesis ; Chikungunya virus - Infectious diseases ; Chikungunya virus - Serology ; Chikungunya virus - Viral infections ; Chikungunya virus - RT-PCR ; Chikungunya virus - Serology ; Chikungunya Virus - Virus ; Chikungunya virus - Chikungunya fever ; Chikungunya virus - Epidemiology ; Chikungunya virus - Public health

Data de publicação: 2007